Healthcare Provider Details

I. General information

NPI: 1518920701
Provider Name (Legal Business Name): CAREN LEE LIPSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD GOOD SAMARITAN HOSPITAL, NICU
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

4641 E CARON ST
PHOENIX AZ
85028-5511
US

V. Phone/Fax

Practice location:
  • Phone: 602-546-0676
  • Fax:
Mailing address:
  • Phone: 480-609-9889
  • Fax: 480-348-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number25064
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: